Relationship Between Serum Iron Profile and Liver Density in Non-Enhanced CT-Scan

  • Alireza Aziz-Ahari Department of Radiology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
  • Mohammadreza Khaleghi Department of Radiology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
  • Zahra Farahani Department of Radiology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
  • Kaveh Samimi Department of Radiology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Keywords:
Liver, Computed tomography, Hemochromatosis, Ferritins

Abstract

It is known that liver biopsy is the gold standard of diagnosing liver iron deposition. By considering liver biopsy complication and cost, introducing a method to restrict unnecessary biopsy or even an alternative for liver biopsy can be useful. This study examined the relationship between serum iron profile and liver density on CT-Scan without contrast material injection. In this study, 76 patients were referred from different Rasoul-Akram Hospital parts in 2015-2016 (People who have undergone abdominal CT-scan for any reason, and blood tests included iron and lipid profiles). To calculate the liver mean density of a CT-scan, densities of 12 sites with an individual area of 1 cm2 on 3 different sections of the liver were obtained, and their average was recorded. Data were analyzed by SPSS V.16 using Kolmogorov-Smirnov,  independent T-test, and two-sample T-tests with a significance level of P<0.05. There is a significant relationship between the serum iron and serum ferritin levels with liver density. By increasing TIBC levels, the difference between liver and spleen densities increases, but no significant correlation was found between TIBC level and liver density. Moreover, there was no relationship between serum iron levels and serum ferritin with the difference between liver and spleen densities. The evaluation of liver density may be an alternative to liver biopsy in some cases or at least can be considered to restrict unnecessary biopsies.

References

1. Lu JP, Hayashi K. Transferrin receptor distribution and iron deposition in the hepatic fobufe of iron‐overloaded rats. Pathology international. 1995 Mar;45(3):202-6.
2. Olivieri NF, Brittenham GM. Iron-chelating therapy and the treatment of thalassemia. Blood. 1997 Feb 1;89(3):739-61.
3. Andrews NC. Disorders of iron metabolism. New England Journal of Medicine 1999 Dec; 23;341(26):1986-95.
4. Wood JC, Mo A, Gera A, Koh M, Coates T, Gilsanz V. Quantitative computed tomography assessment of transfusional iron overload. British journal of haematology. 2011 Jun;153(6):780-5.
5. Gao C, Li L, Chen B, Song H, Cheng J, Zhang X, Sun Y. Clinical outcomes of transfusion-associated iron overload in patients with refractory chronic anemia. Patient preference and adherence. 2014;8:513.
6. Chezmar JL, Nelson RC, Malko JA, Bernardino ME. Hepatic iron overload: diagnosis and quantification by noninvasive imaging. Gastrointestinal radiology. 1990 Dec 1;15(1):27-31.
7. Mills SR, Doppman JL, Nienhuis AW. Computed tomography in the diagnosis of disorders of excessive iron storage of the liver. Journal of computer assisted tomography. 1977 Jan;1(1):101-4.
8. Vaswani LK. Correlation of Tomographic Liver Density with Serum Ferritin Levels in Multiply-Transfused Children with Thalassemia Major SB Bavdekar Priti Ahuja. Indian Pediatrics. 1999;36:383-5.
9. Bavdekar SB, Ahuja P, Vaswani LK. Correlation of tomographic liver density with serum ferritin levels in multiple-transfused children with thalassemia major. Indian pediatrics. 1999 Apr;36(4):383-5.
10. Mitnick JS, Bosniak MA, Megibow AJ, Karpatkin M, Feiner HD, Kutin N, Van Natta F, Piomelli S. CT in B-thalassemia: iron deposition in the liver, spleen, and lymph nodes. American Journal of Roentgenology. 1981 Jun 1;136(6):1191-4.
11. Long JJ, Doppman JL, Nienhus AW, Mills SR. Computed tomographic analysis of beta-thalassemic syndromes with hemochromatosis: pathologic findings with clinical and laboratory correlations. Journal of computer assisted tomography. 1980 Apr;4(2):159-65.
12. Tziomalos K, Perifanis V. Liver iron content determination by magnetic resonance imaging. World Journal of Gastroenterology: WJG. 2010 Apr 7;16(13):1587.
13. Ganz T. Hepcidin, a key regulator of iron metabolism and mediator of anemia of inflammation. Blood. 2003 Aug 1;102(3):783-8.
14. Sherman AR. Zinc, copper, and iron nutriture and immunity. The Journal of nutrition. 1992 Mar 1;122(suppl_3):604-9.
15. Cook JD, Flowers CH, Skikne BS. The quantitative assessment of body iron. Blood. 2003 May 1;101(9):3359-63.
16. Bacon BR, Schrier SL. Patient information: Hemochromatosis (hereditary iron overload)(Beyond the Basics).
17. Long JJ, Doppman JL, Nienhus AW, Mills SR. Computed tomographic analysis of beta-thalassemic syndromes with hemochromatosis: pathologic findings with clinical and laboratory correlations. Journal of computer assisted tomography. 1980 Apr;4(2):159-65.
18. "Hemachromatosis". Encyclopædia Britannica.com. Retrieved 17 April 2017.
19. Tziomalos K, Perifanis V. Liver iron content determination by magnetic resonance imaging. World Journal of Gastroenterology: WJG. 2010 Apr 7;16(13):1587.
20. Pierre TG, Clark PR, Chua-anusorn W, Fleming AJ, Jeffrey GP, Olynyk JK, Pootrakul P, Robins E, Lindeman R. Noninvasive measurement and imaging of liver iron concentrations using proton magnetic resonance. Blood. 2005 Jan 15;105(2):855-61.
Published
2020-02-15
How to Cite
1.
Aziz-Ahari A, Khaleghi M, Farahani Z, Samimi K. Relationship Between Serum Iron Profile and Liver Density in Non-Enhanced CT-Scan. Acta Med Iran. 57(8):499-502.
Section
Articles